Development of a cross-thesaurus with Internet-based refinement supported by UMLS.

Combinatorial terminological systems are appearing, to solve the issues related to flexibility and precision of representation requested by modern healthcare information systems and in particular by messaging standards. The development of a robust system of descriptors ('cross-thesaurus') is a crucial activity in the production of combinatorial terminological systems. We developed a tool (I-BROWSE) to produce a cross-thesaurus by analysing existing terminological corpora. To facilitate the work of experts and to produce re-usable results, our application interacts via the Internet with the UMLS Knowledge Sources Server. We applied our tool on 6372 dissections on surgical procedures produced in the project GALEN-IN-USE, as a part of the internal Quality Assurance Program. Support from UMLS seems mostly promising about descriptors on <anatomy>, <pathological structure>, <pathological process> and <physiological process>. Additional assistance can be given to domain experts on less frequent descriptors on pervasive modifiers. We plan to apply our tool also to production of terminological standards in CEN, as a part of a world-wide process of gradual convergence and transformation of coding systems into second-generation systems and terminological services.